Contribution of age and gender to outcome of blunt splenic injury in adults: Multicenter study of the eastern association for the surgery of trauma

Background : The purpose of this study was to examine the contribution of age and gender to outcome after treatment of blunt splenic injury in adults.Methods : Through the Multi-Institutional Trials Committee of the Eastern Association for the Surgery of Trauma (EAST), 1488 adult patients from 27 trauma centers who suffered blunt splenic injury in 1997 were examined retrospectively.Results : Fifteen percent of patients were 55 years of age or older. A similar proportion of patients >= 55 went directly to the operating room compared with patients < 55 (41% vs. 38%) but the mortality for patients >= 55 was significantly greater than patients < 55 (43% vs. 23%). Patients >= 55 failed nonoperative management (NOM) more frequently than patients < 55 (19% vs. 10%) and had increased mortality for both successful NOM (8% vs. 4%, p < 0.05) and failed NOM (29% vs. 12%, p = 0.054). There were no differences in immediate operative treatment, successful NOM, and failed NOM between men and women. However, women >= 55 failed NOM more frequently than women < 55 (20% vs. 7%) and this was associated with increased mortality (36% vs. 5%) (both p < 0.05).Conclusion : Patients >= 55 had a greater mortality for all forms of treatment of their blunt splenic injury and failed NOM more frequently than patients < 55. Women >= 55 had significantly greater mortality and failure of NOM than women < 55.